Individual provider Active NPI

Andrea Libertucci, LPN

  • Licensed Practical Nurse
  • Schenectady, NY
National Provider Identifier
1124977251
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
301033 Issued in NY
Practice address
217 Stanford Ave
Schenectady, NY 12304-4105
Phone
(518) 867-1105
NPI assigned
Jan 22, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 301033 NY Primary

Addresses

Primary practice location

217 Stanford Ave
Schenectady, NY 12304-4105

Mailing address

217 Stanford Ave
Schenectady, NY 12304-4105
Phone (518) 867-1105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1124977251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 STANFORD AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123044105",
            "telephone_number": "518-867-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 STANFORD AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123044105",
            "telephone_number": "518-867-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERTUCCI",
        "first_name": "ANDREA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "301033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.